The National Pressure Ulcer Advisory Panel (NPUAP) recently made changes to the terminology and system for staging pressure ulcers. The NPUAP, a multidisciplinary group of experts, changed the common term “pressure ulcer” to “pressure injury,” stating the new term is more inclusive and descriptive of both intact and ulcerated skin. Some feel that the change to “injury” will only work in the Plaintiff’s favor in a lawsuit, especially with the public’s perception of pressure ulcers.

Also concerning are some of the changes to staging definitions. For example, the new description for “deep tissue pressure injury” says the wound is the result of “intense and/or prolonged pressure and shear forces at the bone-muscle interface,” conjuring up images of abuse and neglect. In addition, some wording was removed that acknowledged that sometimes even with good clinical care pressure sores can occur.

With the growing opinion that these changes to the terminology and definitions will put caregivers at greater risk for lawsuits, it may be time for providers to put interdisciplinary, personalized plans of care for skin integrity in place. Documenting pressures injuries in detail is a must. They must be staged, measured and documented according to the new staging system. When caregivers do accurate and detailed documentation it will help the Defense counter the Plaintiff’s claims that the standard of care wasn’t met. Defense counsel can use detailed caregiver documentation that shows the caregivers had an interdisciplinary plan of care and that they followed that plan of care including all treatments, referrals and follow ups. This along with strong expert testimony can be used to counter Plaintiff’s claims of abuse and neglect.